Dr. Rebekah Gee, the secretary of health in Louisiana, sent a letter to Cassidy on Monday expressing concern with the bill and saying that the proposal would eviscerate the state’s healthcare system.

“In its current form, the harm to Louisiana from this legislation far outweighs any benefits; therefore I must register our deep concerns and hope we can find a better path forward towards fixing the broken parts of our healthcare system,” Gee wrote.

The bill, called the Graham-Cassidy-Heller-Johnson (GCHJ) plan, would shift federal funding for healthcare to a block-grant system in which states would receive money up front based on the number of enrollees. The current system provides a percentage of the state’s annual healthcare funding, which fluctuates based on how much they spend.

Gee said the proposed shift would be a serious negative for many Louisianians and would “jeopardize coverage for some of our most vulnerable citizens.”

She also took issue with the bill’s elimination of the Affordable Care Act’s Medicaid expansion and the proposed ability for states to obtain waivers that would weaken protections for people with preexisting conditions.

Overall, the state of Louisiana would lose $3.2 billion in federal healthcare funding through 2026 under the legislation, according to a study from the Center for Budget and Policy Priorities. Gee said that would threaten the health of the “most vulnerable Medicaid populations.”

The letter praised Cassidy’s commitment to improving healthcare, but Gee said that his plan fails to make the system better.

“I appreciate your determination to see reform happen.” Gee wrote. “Nevertheless, the legislation you’ve introduced this past week gravely threatens healthcare access and coverage for our state and its people.”

Cassidy responded to Gee by saying that Louisiana will have enough control over its healthcare system to fix the issues she raised. Here’s Cassidy’s statement, which was provided to Business Insider:

“If Dr. Gee had called and asked how this bill would impact Louisiana, she could have been walked through as to why her concerns are unfounded. Instead, she chose to echo a left wing think tank which is working to preserve Obamacare. On the other hand, on one thing, the letter is correct. Our proposal spends less money than Obamacare. We eliminate the penalties paid by individuals and business which do not conform to Obamacare mandates. If Dr. Gee thinks that more money is needed, she should suggest that these taxes be re-imposed on state level. For the record, I oppose this as 58% of individual mandate penalties are paid by families earning less than $50,000 per year. I think these families should be helped, not penalized.